The prognostic significance of p16 overexpression in oropharyngeal squamous cell carcinoma: implications for treatment strategies and future clinical studies

Abstract

Head and neck squamous cell carcinoma (HNSCC) is the sixth common cancer worldwide, with almost 650 000 new cases and 350 000 deaths each year [1]. This group of cancers represent a rather heterogeneous cohort of neoplasms originating from the oral cavity, oropharynx, hypopharynx and larynx. In the last decades, major progress has been made in the treatment of HNSCC, including the addition of concomitant chemotherapy to radiation [2], the use of altered fractionation schedules [3] and, more recently, the use of taxane-based induction chemotherapy [4]. Although outcome in terms of locoregional tumour control and overall survival has been improved significantly with these new strategies, most of these regimens have come to the expense of more severe acute and late treatment-related side-effects. Further treatment intensification will result in a further enhancement of side-effects that may hamper the feasibility of these new regimens. Therefore, in order to improve the therapeutic ratio, a more individualized approach based on specific tumour or patient characteristics that may help to differentiate better between those who will benefit from a more aggressive approach and those who will not is of increasing importance.